胃和肠表型在伴肠母细胞分化胃腺癌中的表达  

Expression of gastric and intestinal phenotypic marker in gastric adenocarcinoma with enteroblastic differentiation

作　　者：苟思琪 张前[1] 方媛 杨路路 王劲松[1] 齐琼[1] 黄文斌[1] GOU Si-qi;ZHANG Qian;FANG Yuan;YANG Lu-lu;WANG Jin-song;QI Qiong;HUANG Wen-bin(Department of Pathology,Nanjing First Hospital Affiliated to Nanjing Medical University,Nanjing 210006,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院病理科,南京210006

出　　处：《医学研究生学报》2020年第10期1066-1070,共5页Journal of Medical Postgraduates

基　　金：南京市医学科技发展项目(YKK17120);南京市卫生青年人才基金(QRX17154)。

摘　　要：目的伴肠母细胞分化胃腺癌(GAED)是新近认识的一种胃癌组织学类型,关于其肿瘤发生的细胞学来源尚不清楚。文中旨在探讨胃和肠表型标志物(MUC2、MUC5AC、MUC6、CD10)在GAED组织中的表达,探讨GAED的细胞来源,进一步评估胃和肠表型与临床病理参数之间的关系。方法收集南京医科大学附属南京医院病理科2015年1月-2018年12月的胃癌根治切除术标本。应用免疫组化EnVision法检测其中43份GAED组织中MUC2、MUC5AC、MUC6、CD10的表达,并根据免疫组化结果分为胃型、肠型、混合型和未分类型。结果 43份GAED中,MUC5AC、MUC6、MUC2和CD10的阳性率分别为16.3%(7/43)、18.6%(8/43)、7.0%(3/43)、4.7%(2/43)。胃和肠表型分型中,67.4%为未分类型,20.9%为胃型,而肠型和混合型均少见。MUC5AC表达在≥60岁GAED患者更高(25.9%vs 0),差异有统计学意义(P<0.05);MUC6在≥60岁和pTNM分期为Ⅲ和Ⅳ期GAED患者表达更高,差异均有统计学意义(P<0.05)。GEAD≥60岁患者中胃型和未分类型更高,差异有统计学意义(P<0.05)。结论 GAED的细胞学来源可能以胃型上皮起源为主。胃和肠表型分类大多为未分类型或胃型。胃和肠表型标志物检测可一定程度上有助于评估GAED的临床生物学行为。Objective Gastric adenocarcinoma with enteroblastic differentiation(GAED)is a newly recognized histological subtype of gastric adenocarcinoma,but the knowledge about cytological origins of the tumor cells is still limited.This study aims to investigate the expression of gastric and intestinal phenotypic markers(MUC5AC,MUC6,MUC2,and CD10)in GAEDs and further evaluate the relationship between gastric and intestinal phenotypes and clinicopathological parameters.Methods Collect samples of radical resection of gastric cancer from January 2015 to December 2018 in the Department of Pathology,Nanjing Hospital Affiliated to Nanjing Medical University.The immunohistochemical EnVision method was used to detect the expression of MUC2,MUC5AC,MUC6,and CD 10 in 43 GAED tissues,and according to the results of immunohistochemistry,they were divided into gastric,intestinal,mixed,and unclassified types.Results The positive rates of MUC5AC,MUC6,MUC2,and CD10 in 43 cases of GAED were 16.3%(7/43),18.6%(8/43),7.0%(3/43),and 4.7%(2/43),respectively.Among the gastric and intestinal phenotypic classification,67.4%were unclassified type and 20.9%were gastric type,while intestinal-type and mixed type were rare.MUC5AC expression in GAED patients≥60 years old was higher than that in GAED patients<60 years old,the difference was statistically significant(P<0.05).MUC6 expression was significantly higher in patients aged≥60 years and pTNM stage III and IV GAED than in patients aged<60 years and pTNM stage I and II(P<0.05).In patients with GEAD≥60 years old,the gastric type and unclassified type were higher than<60,and the difference was statistically significant(P<0.05).Conlusion The cell origin of GAED may be mainly derived from gastric epithelium,and most of their gastric and intestinal phenotypic classification are classified as unclassified or gastric type.The detection of gastric and intestinal phenotypic markers may be helpful to evaluate the clinical biological behavior of GAED to some extent.

关 键 词：胃腺癌 肠母细胞分化 MUC5AC MUC6 MUC2 CD10 胃和肠表型 

分 类 号：R735.2[医药卫生—肿瘤]